ENDOSCOPIC ULTRASOUND - A NEW LOOK AT ACHALASIA

Achalasia is a relatively infrequent disorder of oesophageal motility, and is most often easily diagnosed by stationary manometry showing ab sence of peristalsis and incomplete lower oesophageal sphincter (LOS) relaxation. In rare cases manometric findings may be inconclusive or a malignant underlying disease is suspected. In such cases direct visua lization of the LOS by endoscopic ultrasound (EUS) could contribute to securing the diagnosis and possibly lead to earlier diagnosis and tre atment, With lower frequency EUS, increased thickness of the inner cir cular layer of the muscularis propria may be difficult to detect. Avai lable data suggest that high frequency (20 MHz) and 3-D EUS has a pote ntial to reliably discriminate between achalasia patients and normal s ubjects, and thereby be of diagnostic value. (C) 1998 Lippincott-Raven Publishers.